Recognition of Dissociative Disorder within the NHS and Formation of Appropriate Treatment
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The condition Dissociative Identity Disorder (DID), which is listed within the DSM 5 in the category of Dissociative Disorders; desperately needs wider recognition, acceptance and understanding in the UK.
DID develops during the formative years of childhood. Initially as a coping mechanism for severe, repeated experiences of trauma. In essence, the brain fragments or compartmentalises the different overwhelming emotions, experiences and memories. The formation of dissociated parts enables the person to function to some degree, allowing a separation and disconnect from overwhelming trauma.
A person with DID may present very differently, although often this is not always evident as DID is first and foremost a coping mechanism for survival, hence is not always overtly obvious. This combined with a lack of recognition and understanding can exacerbate how many individuals go undiagnosed or misdiagnosed (with disorders such as, Borderline Personality Disorder - BPD, Eating Disorders, Mood Disorders, Psychotic Disorders etc.) to their detriment. Despite potential symptom overlap, it is important to note, DID and BPD, in particular, are not synonymous.
It is important to acknowledge Dissociative Disorders may encompass a vast range of symptoms which without relevant knowledge causes individuals to be repeatedly let down and labelled, which may lead to inappropriate and often rigid approaches and treatment pathways.
The International Society for the Study of Trauma and Dissociation (2011) estimate a person may be in mental health services for 5-12 years without an accurate diagnosis of dissociative disorder. In addition, research shows that many people with dissociative disorders accrue up to 4 inaccurate diagnoses before receiving a valid diagnosis. Complex Dissociative presentations generally require up to 5-10 years of specialist therapy.
Therefore, such individuals often spend many years in inappropriate placements, receiving a lack of understanding, appropriate treatment or support; often leading to repeated admissions, unsuitable placements and many years of wasted funding (at best, many others go completely unsupported). This leaves the individual and associated services frustrated and no further ahead.
A way to mitigate such circumstances, which have varying degrees of negative impact on all involved, would be to provide relevant specialist training to primary and secondary NHS services. Which would enable earlier recognition and therefore avoid revolving door admissions with no sustainable progress.
There are currently no dedicated solely NHS services for Dissociative Disorders throughout the whole of the UK.
We call on all parties this petition has been issued to, to be proactive in forming appropriate treatment packages for people with Dissociative Disorders. This should be expedited as a matter of urgency, due to desperate need and the lack of current provision.
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